Pamela J Idziorek, RNNP | |
4891 Miller Trunk Hwy, Hermantown, MN 55811-1512 | |
(218) 626-1222 | |
Not Available |
Full Name | Pamela J Idziorek |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Location | 4891 Miller Trunk Hwy, Hermantown, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134235344 | NPI | - | NPPES |
8G561ID | Other | MN | BCBS |
192225400 | Medicaid | MN | |
8G560ID | Other | MN | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | R077946-7 (Minnesota) | Primary |
Entity Name | Twin Ports Dermatology Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316348725 PECOS PAC ID: 0244542454 Enrollment ID: O20150701000157 |
Mailing Address | Practice Location Address |
---|---|
Pamela J Idziorek, RNNP 3920 13th Ave E, Suite 6, Hibbing, MN 55746-3675 Ph: (218) 263-7540 | Pamela J Idziorek, RNNP 4891 Miller Trunk Hwy, Hermantown, MN 55811-1512 Ph: (218) 626-1222 |
Karissa Ann Haugen, PMHNP-BC Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 4891 Miller Trunk Hwy Ste 206, Hermantown, MN 55811 Phone: 218-310-8896 Fax: 218-875-6315 | |
Kimberly Ann Johnson, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4899 Miller Trunk Hwy Ste 208, Hermantown, MN 55811 Phone: 218-727-3888 Fax: 218-260-4772 | |
Michelle L Carl, APRN,CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4855 W Arrowhead Rd, Hermantown, MN 55811 Phone: 218-786-3540 | |
Christie Ehle Erickson Ix, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4855 W Arrowhead Rd, Hermantown, MN 55811 Phone: 218-786-3540 Fax: 218-722-8160 | |
Elizabeth A Maas, APRN, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4190 Loberg Ave, Hermantown, MN 55811 Phone: 218-249-5555 | |
Heather Kay Brown, RN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4855 W Arrowhead Rd, Hermantown, MN 55811 Phone: 218-786-3540 |